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首页> 美国卫生研究院文献>International Journal of Clinical and Experimental Pathology >Characterization of the pathologic and endoscopic measurements of colorectal polyp sizes with a focus on sessile serrated adenoma and high-grade dysplasia
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Characterization of the pathologic and endoscopic measurements of colorectal polyp sizes with a focus on sessile serrated adenoma and high-grade dysplasia

机译：结直肠息肉大小的病理和内窥镜测量的特征侧重于无蒂锯齿状腺瘤和高度不典型增生

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Background: The characteristics of pathologically measured (PMS) and endoscopically measured sizes (EMS) of the colorectal polyps (CRPs) is poorly understood, particularly in polypoid unremarkable mucosa (PUM), sessile serrated adenoma (SSA), and high-grade dysplasia (HGD). Methods: To characterize the discordance and correlation between the PMS and EMS of CRPs including PUM, SSA, HGD, hyperplastic polyp (HP) and adenomas, we conducted this prospective observational study on the polyps collected between August 2012 and December 2013. Results: PMS was significantly smaller than EMS in the 497 qualified CRPs regardless of the sites (left, transverse and right colorectum) or EMS (≥1 cm and <1 cm) subgroups. The PMS and EMS discordance was associated with a diagnosis of HP and adenoma (versus PUM, SSA or HGD), single fragment (versus multiple), 3 of the 8 endoscopists and PMS<1 cm (versus ≥1 cm). Despite a good correlation between EMS and PMS in the adenomas (ĸ=0.626, 95% confidence intervals [CI], 0.505-0.746) and a moderate correlation in the serrated polyps (SPs) including HP and SSA, (ĸ=0.424, 95% CI, 0.244-0.604), 40.4% (23/57) of the adenomas and 63.6% (21/33) of the SPs with EMS≥1 cm might warrant longer follow-up intervals since their PMS were <1 cm. The PMS and EMS had linear correlations except in CRPs with HGD or EMS≥1 cm. Conclusions: The discordance between PMS and EMS is associated with the pathologic diagnosis, fragment number, endoscopists and PMS, and may lead to different follow-ups in a considerable portion of adenomas and SPs.
机译：背景：人们对结直肠息肉（CRP）的病理测量（PMS）和内窥镜测量尺寸（EMS）的特征了解甚少，尤其是在息肉样黏膜（PUM），无蒂锯齿状腺瘤（SSA）和高度不典型增生（ HGD）。方法：为了描述包括PUM，SSA，HGD，增生性息肉（HP）和腺瘤在内的CRP的PMS和EMS之间的不一致和相关性，我们对2012年8月至2013年12月间收集的息肉进行了此项前瞻性观察研究。结果：PMS 497个合格的CRP中的EMS显着小于EMS，而不论其部位（左，横向和右结直肠）还是EMS（≥1cm和<1 cm）亚组。 PMS和EMS的不一致性与HP和腺瘤（相对于PUM，SSA或HGD），单个片段（相对于多个），8个内镜医师中的3个以及PMS <1 cm（≥1 cm）的诊断有关。尽管腺瘤中EMS和PMS之间具有良好的相关性（ĸ= 0.626，95％置信区间[CI]，0.505-0.746），并且包括HP和SSA在内的锯齿状息肉（SP）也具有中等相关性（ĸ= 0.424，95 EMS≥1 cm的SP的百分比CI（0.244-0.604），腺瘤的40.4％（23/57）和SP的63.6％（21/33）可能需要更长的随访间隔，因为其PMS <1 cm。除HGD或EMS≥1 cm的CRP外，PMS和EMS具有线性相关性。结论：PMS和EMS之间的不一致与病理诊断，碎片数量，内镜医师和PMS有关，并且可能导致相当一部分腺瘤和SP的随访不同。

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